Norman L. Berven

Long-term psychosocial outcomes of anterior temporal lobectomy.

Summary:  Purpose: To examine the long‐term psychosocial outcomes of a consecutive series of patients who underwent anterior temporal lobectomy (ATL) compared with medically managed patients. This study focused primarily on actual long‐term changes (mean, 5 years) in life performance. There are relatively few long‐term controlled studies of actual lifetime performance changes.

Measuring social support in rehabilitation

Purpose. To provide a comprehensive and up-to-date literature review of social support and a description of available assessment measures in order to facilitate a theoretical and operational framework for incorporating social support in rehabilitation interventions. Method. An overview of the different theoretical models and conceptual dimensions and a description of specific measures of social support are given. The implications of social support assessment for rehabilitation and recommendations for future research are discussed. Conclusion. To move forward in this area, a consensus on the definition and dimensions of social support needs to occur which could be obtained through an evaluation of existing measures 1. Practitioners and researchers in rehabilitation need to study measures of social support in order to provide empirical support for scales used in professional practice and in research to expand understanding of this important construct.

The Health Action Process Approach as a motivational model for physical activity self-management for people with multiple sclerosis: A path analysis.

OBJECTIVE To evaluate the Health Action Process Approach (HAPA) as a motivational model for physical activity self-management for people with multiple sclerosis (MS). DESIGN Quantitative descriptive research design using path analysis. PARTICIPANTS One hundred ninety-five individuals with MS were recruited from the National Multiple Sclerosis Society and a neurology clinic at a university teaching hospital in the Midwest. OUTCOME MEASURES Outcome was measured by the Physical Activity Stages of Change Instrument, along with measures for nine predictors (severity, action self-efficacy, outcome expectancy, risk perception, perceived barriers, intention, maintenance self-efficacy, action and coping planning, and recovery self-efficacy). RESULTS The respecified HAPA physical activity model fit the data relatively well (goodness-of-fit index = .92, normed fit index = .91, and comparative fit index = .93) explaining 38% of the variance in physical activity. Recovery self-efficacy, action and coping planning, and perceived barriers directly contributed to the prediction of physical activity. Outcome expectancy significantly influenced intention and the relationship between intention and physical activity is mediated by action and coping planning. Action self-efficacy, maintenance self-efficacy, and recovery self-efficacy directly or indirectly affected physical activity. Severity of MS and action self-efficacy had an inverse relationship with perceived barriers and perceived barriers influenced physical activity. CONCLUSIONS Empirical support was found for the proposed HAPA model of physical activity for people with MS. The HAPA model appears to provide useful information for clinical rehabilitation and health promotion interventions.

Quality of Life Among Adults with Epilepsy An Exploratory Model

The last 20 years has seen an increased interest in identifying the factors that affect quality of life for individuals with epilepsy. The great majority of this research has focused on the impact of medical interventions on quality of life. At the same time, increased understanding has developed regarding the significant impact that physical, social, and psychological factors make on the quality of life and life satisfaction of people with epilepsy. In an effort to better understand the relationships of the physical and psychosocial factors to each other and to quality of life among people with epilepsy, the authors developed and evaluated an exploratory model. The results have implications for rehabilitation professionals who work with people with epilepsy.

Complete-link clustering as a complement to factor analysis: A comparison to factor analysis used alone

Abstract The rationale and method of the complete-link hierarchical clustering technique are discussed, along with some recently developed procedures for evaluating an overall clustering solution and for defining an “optimal” partition in a hierarchy. The application of factor analysis prior to clustering is suggested as a means of eliminating variables which do not conform well to the predominant structure in the data; thus, cluster analysis is used as a complement to factor analysis, capitalizing upon the strengths of both techniques. The advantages of the suggested method are then demonstrated using a previously published task analysis study of the roles and functions of the rehabilitation counselor. In comparing the obtained solution to the original factor analytic solution, it is argued that the two were generally consistent and that differences observed favored the clustering solution in terms of greater meaningfulness and homogeneity of the groupings. In addition, the clustering solution offered further advantages in the substantive interpretation of the data.

Community integration: conceptualisation and measurement

Purpose. To provide an overview of the conceptualisation of community integration as proposed in the literature, to review select measures of community integration that have been frequently used in disability and rehabilitation, and finally, to discuss future directions for community integration research. Method. Review of select measures published in PsycInfo- and PubMed-indexed literature representing a width of community integration conceptualisations. Conclusions. A variety of measures have been developed and validated in disability and rehabilitation research addressing different models of community integration, with additional measures originally developed in the adjacent disciplines presenting potential for application to research in community integration for individuals with disabilities. Research is needed to further clarify the multidimensional nature of community integration and to develop sound measures of community integration. To the extent that community integration is a function of various factors (e.g. individual and contextual) and involves multiple dimensions (e.g. physical, social and psychological), the advancement in research in this area should, in turn, contribute to planning and implementation of interventions directed at individual and societal levels, including relevant policymaking, towards expansion of community integration.

Factors affecting depression among people with chronic musculoskeletal pain: A structural equation model

Objective: To adapt and test P. M. Lewinsohn, H. M. Hoberman, L. Teri, and M. Hautzinger’s (1985) integrative model of depression for individuals with chronic musculoskeletal pain. Design: Structural equation modeling. Participants: Individuals with chronic pain (N 171), recruited from 6 outpatient rehabilitation facilities in Canada. Outcome Measures: Two measures of the latent variable, depression (the Center for Epidemiologic Studies—Depression Scale and the Zung Self-Rating Depression Scale), along with multiple measures of each of 5 latent predictors (pain, interferences, stress, coping, and social and family support) and 2 measured predictors (preinjury psychopathology and catastrophizing). Results: The normed fit index, comparative fit index, and parsimony ratio indicated an adequate fit for the model, suggesting that stress, perceived severity of pain, activity interferences, and catastrophizing contributed to increased depression (vulnerabilities), whereas pain coping skills and social and family support contributed to decreased depression (immunities). Conclusions: Empirical support was found for the proposed model of depression for people with chronic musculoskeletal pain, and the model appears to provide useful information for clinical rehabilitation interventions.

Functions and Knowledge Domains for Disability Management Practice: A Delphi Study.

The importance of job functions and knowledge domains to the practice of disability management was examined by systematically obtaining the opinions of a panel of 44 recognized experts in disability management. As proposed by Habeck and Kirchner (1999), disability management was conceptualized at two levels of practice. Level I (DM) was defined as administrative and managerial in nature, with an organizational focus. Level II (dm) was conceptualized as human-service oriented, involving the direct provision of services to individual clients. The results indicated that many functions and knowledge domains that appear to be generally important to disability management practice, while others appear to have greater or lesser salience depending on whether services are focused at the organizational or individual level of intervention.

Willingness of Graduate Students in Rehabilitation Counseling to Discuss Sexuality with Clients.

The purpose of this study was to obtain a greater understanding of the willingness of graduate students in rehabilitation counseling to discuss sexuality with clients.This was done by testing a model of factors predicted to influence the willingness of rehabilitation counseling master’s students to discuss sexuality with clients, using path analysis.The results of this study suggest that sexuality knowledge, sexuality education, attitudes toward the sexuality of people with disabilities, and comfort with sexuality affect the willingness of rehabilitation counselors to discuss sexuality with clients, with sexuality knowledge and comfort with sexuality having direct effects on willingness. Understanding the relationships between these variables may facilitate the design of interventions that promote the willingness of rehabilitation counselors to discuss sexuality with clients.

Stages of change and physical activity among individuals with severe mental illness.

OBJECTIVE To apply the constructs of the transtheoretical model (TTM) of change to understand physical activity among individuals with severe mental illness. METHOD Predictions of stages of change of physical activity and self-reported physical activity were investigated among 92 adults with severe mental illness, using cognitive and behavioral processes of change, self-efficacy, and perceived pros and cons of exercise as predictors. RESULTS Separate logistic regression analyses for adjacent pairs of stages indicated that 33% of the variance was accounted for when predicting preparation versus action/maintenance stages, with behavioral processes making a significant unique contribution to prediction. A multiple-regression analysis was conducted to examine prediction of self-reported physical activity on the basis of all of the TTM measures, and the full model accounted for nearly 27% of the variance. CONCLUSION Results suggest that TTM constructs hold promise in understanding physical activity of people with severe mental illness with significant implications for clinical practice and future research.